陕西省发热呼吸道症候群病原谱和呼吸道合胞病毒基因特征

Analysis the viral etiology of fever and respiratory tract infection syndrome in Shaanxi province during 2010

目的分析陕西省发热呼吸道症候群患者咽拭子中16种呼吸道病毒病原谱构成和呼吸道合胞病毒基因特征。方法2010年1月至2011年1月收集符合监测定义患者咽拭子标本208份，采用基于毛细管电泳的多重RT-PCR反应进行病毒核酸检测，包括人鼻病毒（HRV）、冠状病毒（HCOV）、流感病毒（Flu）、副流感病毒（HPIV）、腺病毒（ADV）、呼吸道合胞病毒（HRSV）、人偏肺病毒（HMPV）以及博卡病毒（HBOV），并对其中HRSV检测阳性的标本进行G基因羧基末端测序与种系进化分析，研究流行于陕西的HRSV分子流行病学特征。结果总病毒检出率为53％（109／208），检测到的阳性病毒病原构成率分别为：HRSV42．2％、Flu24．5％、PIV20％，HRVl3．6％，ADVl0．9％，HCOV7．3％、HMPV4．6％和3份HBOV2．7％。有20％（22／109）病例为混合病毒感染，其中有14例为PIV与其他病毒混合感染，15～39岁年龄组混合感染率最高，差异有统计学意义（P〈0．05）。总呼吸道病毒的感染率在各年龄组中差别不大，除Flu、HMPV和PIV外，其他病毒（HRV、HBoV、HCoV、ADV、HRSV）的感染人群主要以0～4岁小儿为主。46例多重RT—PCRHRSV阳性病例中，42例为HRSVA血清型的NA1基因型；2例为B血清型，其中1例为BA9基因型，1例为GB2基因型。结论陕西发热呼吸道症候群由多种呼吸道病毒引起，存在2种或以上病毒的混合感染，其中以PIV与其他病毒混合感染为主。HRSV是2010年陕西省发热呼吸道症候群的主要病原，其中A血清型的NA1基因型是陕西2010年流行的绝对优势型别。

Objective Analysis the viral pathogenic spectrum for patients with fever and respiratory tract infection syndrome in Shaanxi province during 2010 and investigate the molecular epidemiology characteristics of respiratory syncytial virus. Methods A total of 208 patients＇ pharyngeal swabs were collected based on surveillance definition from January 2010 to January 2011 and screened for sixteen human respiratory virus types/subtypes by Qiaxcel-based multiplex reverse transcription-PCR assay, including HRV, HCoV, Flu, HPIV, ADV, HRSV, HMPV and HBoV and investigate molecular epidemiology of HRSV by sequencing and phylogenetic analysis of the C-terminal second hypervariable region of the G gene. Results 109 out of 208 specimens （53%） were positive for one or more viruses. HRSV（42. 2% ） was the dominant pathogen detected, followed by Flu （ 24.5 % ）, PIV （ 20% ） , HRV （ 13.6% ） and ADV （ 10.9% ）, there were also 8 strains of HCoV,5 strains of HMPV and 3 strains of HBoV detected. The results showed that 22 specimens were positive for two or more viruses, PIV （14/22） was the most frequently detected viral agent among co-infection specimens, and the highest incidence of mixed infection is aged 15-39 years group （P 〈 0. 05）. The overall viral detection rate was no related to age. In addition to Flu, HMPV and PIV, other viruses （HRV, HBoV, HCoV, ADV, RSV） mainly infected 0 to 4 years old children. Among 46 HRSV positive specimens, 42 HRSV-A strains clustered into NA1 genotype and two HRSV-B strains clustered into two genotypes, BA9 and GB2. Conclusion HRSV is the dominate pathogen collected from patients with fever and respiratory tract infection syndrome in Shaanxi and YIRSV A is the predominant subtype. For most viruses, infection was most prevalent among children aged 〈 4 years. PIV was the most common pathogen in co-infection.